Calcaneal fractures are typically caused by a high-velocity impact to the heel (for example, a fall from a height of at least two meters or an impact as a result of a motor vehicle accident). Calcaneal fractures may be extra or intra-articular.
One method currently used for treatment of calcaneal fractures is surgical treatment with open reduction and internal fixation, to restore the articular surface of the calcaneus and to obtain an anatomic reconstruction (height and width of the calcaneus). Although open reduction and internal fixation of intra-articular calcaneal fractures has become a standard surgical procedure with relatively low complication rate, there are still problems associated with this technique, primarily because of the complicated physical arrangement of the articular surfaces of the calcaneus (calcaneal bone). Clinical and technical problems can also occur due to the thickness and the stiffness of the plates, in particular superficial necrosis of the surgical wounds and peroneal tendonitis. These problems are related to the traction onto the skin flap during surgery and to the thickness of the plates that may cause ischemic problems to the skin and impingement of the peroneal tendons.
In addition, most plates have a limited number of holes and do not allow for significant molding because of their thickness. In this situation, the screws have to be inserted in predetermined sites of the calcaneal wall, and especially in the fractured zones of the lateral calcaneal wall, in the small fractures. Sometimes, this can lead to insufficient grip of the screws and therefore insufficient mechanical resistance of the implant. In those circumstances, early movement to prevent joint stiffness and enhance fractured soft tissue healing is not possible.
Accordingly, there is a need for better compression and load distribution between the articular surfaces of a fractured calcaneus, with increased stability by locking screw fixation and bridging of the fracture line. A plate with a step configuration that confers improved remodeling according to the lateral wall of the calcaneus and that is suited to the mechanical and biological characteristics of the method (open reduction and internal fixation) of intra-articular calcaneal fractures, with improved results, is also needed. A calcaneus correction osteotomy plate that reduces irritation of soft tissues and tendons, and decreases the number of late complications necessitating corrective procedures occurring subsequent to the fracture treatment, is also needed.